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Ethics roundtable debate: Child with severe brain damage and an underlying brain tumour
Authors:Scott Gunn  Satoru Hashimoto  Michael Karakozov  Thomas Marx  Ian KS Tan  Dan R Thompson  Jean-Louis Vincent
Affiliation:(1) Assistant Professor of Critical Care Medicine and Emergency Medicine, Department of Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA;(2) Director of Intensive Care Division, Associate Professor, Department of Anesthesiology and Intensive Care, Kyoto Prefectural University of Medicine, Kyoto, Japan;(3) Intensivist ICU, Republican Hospital of Karelia Petrozavodsk, Petrozavodsk, Russia;(4) Private Docent (Reader), Staff Anaesthesiologist, Consultant ICU Department, Department of Cardiac Surgery, University of Ulm, Ulm, Germany;(5) Ian KS Tan, Consultant Intensivist, Department of Intensive Care Medicine, Singapore General Hospital, Singapore;(6) Associate Professor, Department of Surgery and the Center for Medical Ethics, Education and Research, Albany Medical College, Albany, New York, USA;(7) Professor, Head, Department of Intensive Care, Erasme Hospital (Free University of Brussels), Brussels, Belgium;
Abstract:A young person presents with a highly malignant brain tumour with hemiparesis and limited prognosis after resection. She then suffers an iatrogenic cardiac and respiratory arrest that results in profound anoxic encephalopathy. A difference in opinion between the treatment team and the parent is based on a question of futile therapy. Opinions from five intensivists from around the world explore the differences in ethical and legal issues. A Physician-ethicist comments on the various approaches.
Keywords:critical care   ethics   medical futility   negotiating   palliative care
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